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Cited by 75Telemedicine and Telehealth ImplementationMusculoskeletal pain and rehabilitationOpioid Use Disorder Treatment

The DOI matches its Crossref record; 91 of the 91 references it cites were found in a registry or an index.

Optimizing telehealth pain care after COVID-19

Open access
Tauben, David J., Langford, Dale J., Sturgeon, John A., Rundell, Sean D., Towle, Cara, Bockman, Christina, Nicholas, Michael·2020·Pain
DOI 10.1097/j.pain.0000000000002048PMC PMC7566302
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Abstract

“If you have ever thought of doing telehealth, now's the time to get started.” —Peter McGough, MD (Medical director of the University of Washington neighborhood clinics: KUOW/National Public Radio, 2020.) 1. Introduction The COVID-19 pandemic has presented major challenges to pain care, as pain clinicians face severe restrictions in their ability to provide usual in-person assessments and treatments. COVID-19 has also exposed prepandemic problems in providing comprehensive pain care. Yet, despite this crisis, there have been encouraging developments for long-term delivery of pain services, most notably the explosive growth in the adoption of telehealth technology and clinical resourcefulness in its applications. Furthermore, the size and urgency of the COVID-19 pandemic has seen many cumbersome local, regional, and national health policy rules regarding the access, delivery, and reimbursement of telehealth temporarily waived. These changes have afforded an opportunity to develop new ways of operating and a glimpse of how life could be for pain services under a “new normal.”81 Importantly, telehealth has the potential to transform pain management, particularly for those with complex pain care needs living remotely from pain facilities or in low-resource settings, removing barriers to multidisciplinary pain management delivered in a collaborative, interdisciplinary way—the optimal treatment approach for chronic pain.21 Pain researchers have provided timely reports of the available evidence for treatment modalities capable of being delivered remotely.25,81 However, the provision of pain services at local, regional, and national levels entails more than a consideration of evidence for individual service components. A broader framework is needed. This topical review considers the value case for telehealth-based multidisciplinary pain management approaches, reviews available evidence, delineates obstacles, and proposes solutions across the domains of health systems, public health, and reimbursement policies. We should not turn back; rather, we should advance the potential gains of telehealth pain services. At the same time, it is imperative that we implement a research agenda evaluating outcomes, costs, and acceptability alongside these new clinical developments. 2. What is telehealth? Telehealth is expansively defined as the use of technology (electronic information and telecommunication) to facilitate long-distance health care, health-related education, public health, and health administration.11,45 Available methods for the delivery of technology-enabled care currently include synchronous (eg, live videoconferencing), asynchronous (eg, store-and-forward transmission of photographs, images, vital signs, and video clips for later review), mobile health (M-Health) (eg, remote patient monitoring and patient-reported outcomes), and electronic health (E-Health) (eg, live or recorded educational presentations to geographically disparate groups of patients or healthcare professionals). Each method has the potential to fill specific gaps in pain management, offering unique promise for chronic pain management. In addition to research opportunities, these developments present important training imperatives as well. 2.1. Pain medicine by telehealth Despite strong support for the value of telehealth across a range of medical disciplines and methodologies,7,13,16,29,30,52,55,61,79,88,93 recent recommendations for pain management during the COVID-19 crisis have identified only a time-limited role for synchronous delivery of telehealth care.19 Based on telehealth's demonstrated ability to improve access, collect and interpret health data, and provide educational consultative support for care by multiple medical disciplines, and considering the recent surge in implementation, there may be a case for a more permanent response beyond COVID-19. Pain medicine clinicians can interview, observe, and counsel patients with chronic pain through audiovisual technologies. However, performing the physical examination remotely remains a vexing challenge. This is a crucial portion of accurate and thorough diagnostic evaluation of patients with chronic pain, needing to touch, press, palpate, and move patients. This challenge can be overcome, in part, by the presence of an on-site medical clinician seeking consultation, or with less easily accomplished instructional coaching by an attendant caregiver, but these may not always be available.93 Telehealth peripherals (eg, electronic stethoscopes, teleophthalmoscopes, and video-otoscopes93) are common assessment tools for remotely delivered primary health care. Pain assessment questionnaires, an established component of pain assessment,14 are similarly M-Health peripherals that we have successfully introduced before the telehealth visit through premailed, electronic health record (EHR) “patient portal”97 or mobile devices.76 A promising alternative to new patient assessment under COVID-19 restric

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  1. Holpuch, 2020, Us's digital divide 'is going to kill people' as COVID-19 exposes inequalities, The Guardian

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Metadata

Authors
Tauben, D. J., Langford, D. J., Sturgeon, J. A., Rundell, S. D., Towle, C., Bockman, C., & Nicholas, M.
Affiliations
  • University of Washington (US)
  • Anesthesiology & Pain Medicine
  • The University of Sydney (AU)
Corresponding author
Tauben, David J.
ORCID
Venue
Pain
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2020-08-20
Volume
161
Issue
11
Pages
2437-2445
ISSN
  • 0304-3959 (ISSN-L)
  • 1872-6623
DOI
10.1097/j.pain.0000000000002048
PMC
PMC7566302
OpenAlex
W3080095160
Cited by
75
References
91
Citations by year
2026: 10 · 2025: 10 · 2024: 11 · 2023: 14 · 2022: 17 · 2021: 12 · 2020: 1
FWCI
1.84
Type
journal article
Language
en
Open access
Licence
Locations
  • Pain (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • The Sydney eScholarship Repository (The University of Sydney) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Keywords
telemedicine, pain management, chronic pain, multidisciplinary pain management, COVID-19 pandemic, telemedicine regulation, remote patient monitoring, mobile health, health system barriers, resource-limited settings, health policy, telehealth adoption, videoconferencing, store-and-forward telemedicine, patient-reported outcomes
MeSH terms
Betacoronavirus, COVID-19, SARS-CoV-2, Behavior Therapy, Humans, Pain, Pneumonia, Viral, Telemedicine, Coronavirus Infections, Physical Therapy Modalities, Pandemics, Pain Management

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